The Opioid Epidemic

The Opioid Epidemic

The Opioid Epidemic 150 150 Peter

The Opioid Epidemic

INSTRUCTIONS
The OPIOID EPIDEMIC will be the health problem for my capstone.

In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Which will be OPIOID EPIDEMIC health problem. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. My part will be to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.

Introduction
Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

● Develop a problem statement for a patient, family, or population that’s
relevant to your practice.
● Begin building a body of evidence that will inform your approach to your
practicum.
● Focus on the influence of leadership, collaboration, communication,
change management, and policy on the problem.

Preparation
In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Which will be an OPIOID EPIDEMIC health problem. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective.

During this time, you may also choose to consult with the subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:
● Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
● Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

In addition, you may wish to complete the following:
● Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
● Review the Practicum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.

Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Sample Paper

The Opioid Epidemic

Problem Definition

Summary

The opioid epidemic refers to a national healthcare crisis in the United States. Its origins trace back to the late 1990s when pharmaceutical companies stated that opioid-based medicines do not pose an addiction threat (U.S. Department of Health and Human Services, 2021). Consequently, there was a surge in the prescription of opioids, leading to large-scale misuse, both with and without prescription. Thus, the opioid epidemic represents a national substance abuse problem that has affected millions of people through addiction, poor general physical and mental health, and death. Hence, while there has been extensive research on the issue, there is the need to continue exploring the problem from a perspective of public and community health.

Patient/Family/Group for Practicum Project

The opioid epidemic will be the backbone of the practicum project. The crisis has affected almost all demographic groups. However, some groups do not have equal capacity and access to healthcare services to address the problem. Hence, the focus group for the practicum project is African-Americans.

Substantiating the Problem

African-Americans have been hit hard by the upsurge in opioid misuse and abuse in the 2010s. For example, death rates among middle-aged African-Americans more than doubled between 2013 and 2017 (Lippold et al., 2019). Meanwhile, around the same time as the increase in opioid abuse-based deaths, over ten percent of African Americans did not have medical insurance, with most of the insured relying on government-funded insurance (Carratala & Maxwell, 2020).

Therefore, the opioid epidemic led to a crisis that transcended treatment rooms. Not only were people susceptible to the drawbacks of opioid misuse, but some also did not have the financial capacity to address the problem. For instance, non-Hispanic whites had a higher rate of opioid abuse incidence in the 2010s than Blacks. However, the increase in death rates was reversed, with Blacks recording a 43% rise, compared to 22% among Whites (James & Jordan, 2018). This disparity in outcomes demonstrates the inequity with the healthcare infrastructure, making it harder for an African-American to overcome an opioid abuse problem.

Relevance to Practice

The practicum project aims at exploring the opioid epidemic further within the context of the identified group. It will facilitate the student gaining invaluable experience and knowledge in recognizing community health needs. Furthermore, the practicum will enhance the student’s ability to contextualize health problems within a social, political, and legal framework. Finally, choosing a problem as pertinent as the opioid epidemic will enable real-time insights into healthcare equity and disparity.

Literature Review and Analysis

Most research articles and professional organizations present the opioid epidemic as a grave concern for the American population. For example, the U.S. Department of Health and Human Services (2021) notes that 1.6 million Americans had an opioid-use disorder within the last year. About three-quarters of a million had used heroin. Consequently, the nation recorded over 70,000 deaths related to drug overdose in 2019. This presentation is consistent with what healthcare providers experience in their care settings. Whether it involves a critical case of physical and mental health deterioration or a relatively milder dependence incidence, caregivers regularly encounter patients with an opioid-use disorder. The consequences for such patients vary but are all very significant. Death, loss of functionality (physical or mental), and socio-economic impact (such as job loss and severing of family/community ties) occur to most opioid-related patients that caregivers meet. Hence, the literary presentation of the problem is accurate.

The data from the various sources is also complete and accurate, hence reliable. For instance, The National Academies of Science, Engineering, and Medicine (2017) published and discussed data and information on substance abuse spanning several decades. The insights that the authors draw represent a complete picture of the epidemic. Furthermore, the inclusion of different healthcare stakeholders from varying settings makes the data applicable to all scenarios.

Different healthcare entities have attempted to develop solutions for the opioid epidemic. Unfortunately, some solutions have not been implemented, and those that have are not fully effective. The limited success stems from several barriers that hinder evidence-based implementation. These hindrances include stigma, inadequate professional capacity, and system-based challenges. Stigmatization prevents an earnest discussion, exploration, and resolution of opioid misuse, especially within a family context. The addicted individuals often want to hide their struggles from their spouses, siblings, and other family members for fear of appearing weak or an embarrassment (The National Academies of Science, Engineering, and Medicine, 2019). Unfortunately, the most effective interventions require family involvement. When a caregiver cannot convince the patient to involve the family, it limits success. Next, most caregivers lack enough knowledge and skills to handle opioid-use disorders. Therefore, even if the solutions are potentially impactful, the lack of competent implementors hinders their success. Finally, system-based challenges such as legal obligations, health insurance policy terms, and lack of reimbursement incentives dissuade patients and caregivers from seeking the best possible outcomes. Therefore, most patients refrain from healthcare settings to avoid further ramifications of their health problems.

The National Academies of Science, Engineering, and Medicine (2017) describe a systems approach to addressing the opioid epidemic. The researchers developed various policies to enhance outcomes related to opioid use disorders. Their approach originates from three major strategies: reducing the supply of addictive substances, lowering demand, and reducing the risk that consuming the substance poses. First, healthcare stakeholders should lessen the ease of access to opioids. For instance, they can schedule opioid-containing medicines under the Controlled Substance Act. Such action will reduce their over-the-counter availability. Also, stricter rules for malpractice under the new schedules will enforce the regulation. Legal and political efforts to reduce the entry, production, and refining of opioids will also lower their supply. Hence, it will be difficult for someone to buy opioids from a local drug dealer, resulting in fewer abuse cases.

Next, healthcare stakeholders should seek to reduce the need for opioids. Opioids are mainly used to relieve pain. However, there are other pain-relieving techniques. For instance, non-pharmacological approaches can address chronic pain that accompanies illnesses such as arthritis, cancer, and skeletal and deep-tissue injuries. Interventions such as yoga, acupuncture, and hydrotherapy are good alternatives to pain medication. When the community has more access to facilities offering these services, there will be less demand for pain medication, most of which is opioid-based.

Finally, national health agencies such as the FDA, CDC, and NIH can create new guidelines for the formulation and prescription of opioids. The aim is to expose patients to addiction as low risk as possible. Reducing opiate content in the medicine and creating conservative prescription protocols will ensure that people enjoy the pain-relieving benefits of opioids without the risk of addiction.

Nurses’ role in policymaking will include presenting data, highlighting the efficacy of proposed policies, and professional improvement. Among all caregivers, nurses spend the most time with patients and community members. Therefore, they have a detailed perspective of healthcare problems. In this case, nurses should present their insights to policymakers to fully explore the issue. They should also highlight any barriers that may exist in implementing specific strategies. Finally, nurses should prepare professionally to implement solutions through continuous training and education. In so doing, they will have contributed to the policymaking process.

Jean Watson’s Theory of Transpersonal Caring is ideal for the practicum. It captures the specific setting and needs involving opioid abuse for the minority group. For instance, its pillars of interpersonal care provision, wholistic growth (individual and family), and a dynamic care environment provide a sufficient framework to explore the problem (Gonzalo, 2021). Additionally, the theory’s conceptualization of society offers a multidisciplinary basis for combating the opioid epidemic.

State Board Nursing Practice Standards

State Nursing Boards standards can be crucial to the outcomes of opioid-use interventions. For instance, they can enhance public education to reduce stigma. They can also offer training to caregivers to improve their capacity to deal with opioid use disorders. Lastly, state nursing boards can develop and enhance policies that reduce the supply of opioids, especially if data shows that most drugs originate from that region. Nurses can influence the nursing board policies by contributing their experience to the process. Their close relationship with the community affords them a unique perspective on healthcare issues, making them prime candidates for enhancing policy effectiveness.

Unfortunately, some states have limited practice scope for nurses. These limitations derail nurses’ impact on policies meant to address the opioid epidemic. For instance, where nurses are not regarded as equal care partners but as assistants, their opinion is deemed uninformed. Thus, the senior medical practitioners involved in policymaking do not have an interpersonal understanding of the issue.

Leadership Strategies

Bergstedt & Wei (2020) explored how nurses can develop effective leadership strategies. The study results showed that creating common values, pursuing higher education and competencies, providing resources for professional growth, and engaging in transformational leadership were all crucial to effective nursing leadership. These approaches will allow a nurse leader to influence their unit towards addressing various needs related to opioid use disorders. For instance, the team will be more competent, portray cultural competence and have adequate knowledge in available community resources to help patients.

Hence, leadership will play a crucial role in addressing the opioid epidemic among African-Americans. Leaders will organize their teams in identifying specific needs and implementing high-quality, professional interventions. They will also influence policymaking to ensure that the environment is conducive to combating opioid use disorders at an individual and community level.

Achieving such high levels of leadership effectiveness requires sound change management strategies. The leader must push their teams from the relative incompetence to excellence. A four-phase approach, which includes defining problems and expectations, planning to make changes, implementing them, and developing a sustainability framework (The Society for Human Resource Management, 2021) would suffice. The process is elegant and will minimize transitional workplace dissatisfaction while enhancing competence in addressing opioid use disorders among African-Americans.

Finally, nurses must collaborate with other stakeholders to address the opioid epidemic. For instance, they can lobby legislators to pass specific laws that benefit the discontinuation of opioid abuse. Nurses can also collaborate with researchers and pharmaceutical companies to develop less-risky drugs. Consequently, consuming opioid-based medicine will present less risk of addiction.

Conclusion

The opioid epidemic requires dedicated attention from the nursing fraternity. Nurses should determine how the problem affects various communities and develop specialized interventions. The current practicum project focus on African-Americans and the role that nurse and nurse leaders can play in improving outcomes related to opioid-use disorders.

 

References

Bergstedt, K., & Wei, H. (2020). Leadership strategies to promote frontline nursing staff engagement. Nursing Management, 51(2), 48-53. DOI: 10.1097/01.NUMA.0000651204.39553.79

Carratala, S., & Maxwell, C. (2020, May 7). Health Disparities by Race and Ethnicity. https://www.americanprogress.org/article/health-disparities-race-ethnicity/

Gonzalo, A. (2021, Mar. 5). Jean Watson: Theory of Human Caring. https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/#theory_of_human_caring_of_jean_watson

James, K., & Jordan, A. (2018). The Opioid Crisis in Black Communities. The Journal of law, medicine & ethics, 46(2), 404–421. https://doi.org/10.1177/1073110518782949

Lippold, K. M., Jones, C. M., Olsen. E. O., & Giroir, B. P. (2019). Racial/Ethnic and Age Group Differences in Opioid and Synthetic Opioid–Involved Overdose Deaths Among Adults Aged ≥18 Years in Metropolitan Areas — United States, 2015–2017. MMWR Morb Mortal Wkly Rep, 68, 967–973. http://dx.doi.org/10.15585/mmwr.mm6843a3

The National Academies of Science, Engineering, and Medicine. (2017). Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. National Academies Press.

The National Academies of Sciences, Engineering, and Medicine. (2019). Medications for Opioid Use Disorder Save Lives. National Academies Press